Complementary health insurance: is it worth it?

What the gap looks like

The CNS is broad. As covered in the CNS explained, the system reimburses outpatient care at the conventional tariff and direct-bills hospital stays under the standard regime. The places where it visibly does not cover residents are predictable, and they are precisely the categories complementary insurance addresses:

• Private hospital room. The differential between a shared room (covered) and a single room with private bathroom is patient-billed. A multi-day stay turns this into the largest single complementary-insurance payout most residents ever see.
• Dental beyond the CNS ceiling. Routine care is reimbursed up to a periodic ceiling in the nomenclature; anything above is patient-billed. Orthodontics is reimbursed only within strict age and condition criteria.
• Optical. The CNS pays flat rates for frames and lenses that fall well short of typical retail prices.
• Non-conventioned specialist excess. Where a specialist operates hors convention, the CNS reimburses only up to the conventional tariff; the excess is the patient's.
• Some preventive and alternative care. Osteopathy under prescription is partly covered; many other alternative therapies (acupuncture, homeopathy, some preventive screenings) sit outside.

A complementary plan's policy schedule reads almost as the inverse of this list: a column of categories that maps to exactly the categories above. The economic logic of the complementary market is that the gap is well-defined and predictable, so the insurer can price the cover tightly.

The main providers

The Luxembourg complementary market is concentrated around a handful of providers, each with a distinct positioning. None of them is unambiguously "the best"; the right choice depends on the tier wanted, the family composition and the appetite for worldwide cover.

CMCM — the mutual

The Caisse Médico-Complémentaire Mutualiste is the historic mutual society for complementary cover in Luxembourg. It is non-profit, member-owned, and has by far the largest membership base in the country. CMCM is known for low premiums on its basic tiers, broad accessibility (most subscribers are accepted on standard terms), and a simple reimbursement workflow that integrates closely with the CNS-issued memoire d'honoraires. It is the default starting point for many residents, especially at the basic and standard tiers.

DKV Luxembourg

DKV (with German-Belgian background, part of the wider Munich Re group) is a commercial insurer with a strong presence on premium and worldwide-cover products. DKV is known for flexible tier design, products aimed at expatriates and cross-border populations, and add-on modules — international hospital cover, repatriation, alternative medicine — that match the needs of internationally mobile residents.

Foyer Health

Foyer Health is the health line of the wider Foyer group, the largest domestic insurance group in Luxembourg. It offers a full ladder of complementary products from basic to premium, often bundled with other Foyer cover (home, car, life), with strong domestic distribution and frequent integration with employer-sponsored group plans.

La Luxembourgeoise

La Luxembourgeoise is a domestic mutual-holding group with a long history in the Luxembourg market, offering complementary health alongside life and pension products. It is known for stable pricing across tiers and a focus on the resident family market.

Others

Allianz Care, Bâloise and a few smaller players also write complementary health insurance in or for Luxembourg, often in connection with international-mobility group contracts arranged through employers in the financial sector. All authorised insurers in Luxembourg are supervised by the Commissariat aux Assurances (CAA), which licenses each product and approves the contractual terms.

How tiers are structured

Most complementary insurers structure their products in three or four tiers, in ascending order of premium and coverage:

• Basic. Covers the private hospital room differential and a slice of dental beyond the CNS ceiling. Often the cheapest tier and, for many young residents with no recurring health spend, the rational starting point.
• Standard. Adds higher dental ceilings, an optical envelope (frames + lenses periodically), and some preventive-medicine cover.
• Premium. Adds worldwide cover, hospital VIP options (single room with comfort items), alternative medicine, orthodontics for children at higher ceilings, and broader maternity cover.

The relevant figures — premium per month, dental ceiling per year, optical ceiling per period, hospital VIP supplement — vary by insurer and by tier. We do not state current-year amounts on this page because they move; always read the insurer's product schedule and the CAA-approved policy conditions. Where this page mentions a structural feature, the principle is stable; where it touches on a price, treat it as [verify with the insurer brochure].

Family vs single

Two structural points decide the family economics. First, premium tiers can scale up sharply with family size — some insurers price per insured individual, others charge a family-rate plus a per-child supplement. Second, and more important: check whether the dental ceiling is per person or per family. A per-family ceiling that looks generous in absolute terms can be exhausted by one child's orthodontics; a per-person ceiling is materially more useful for a household with two or more children entering the orthodontic age range.

Similarly, optical ceilings are usually per person and per defined period (commonly two years), but the period definition varies — some insurers count rolling 24 months, others use calendar-period anchoring. For a household with multiple wearers of glasses, the difference is meaningful.

For young singles, the basic tier is almost always sufficient. For households planning maternity, with school-age children, or with predictable dental work, stepping up to standard or premium is usually rational — but the lift is in the dental and maternity envelope, not in the headline "premium" badge.

Pre-existing conditions and waiting periods

Complementary insurers in Luxembourg conduct underwriting at subscription. Most require a medical declaration with a defined questionnaire — chronic conditions, ongoing treatments, recent hospitalisations. A pre-existing condition declared at subscription is typically either covered with an exclusion clause for that specific condition, or accepted with a surcharge on the premium, or refused outright depending on severity. Disclosing is non-negotiable: a non-declared pre-existing condition discovered later can void the policy retroactively.

On top of underwriting, contracts impose waiting periods on the categories most exposed to anti-selection:

• Dental — typically several months before standard reimbursement applies, with longer waiting periods on orthodontics and major dental work.
• Optical — typically several months before the periodic envelope is available.
• Maternity — typically around 9–10 months from policy inception, with the underlying logic that the cover should not be subscribed only to claim an immediate, known expense.

Some insurers waive or reduce waiting periods when an employer-sponsored group policy is switched to an individual policy, or when a member transfers between products within the same insurer. Ask before subscribing if you have a planned event on the horizon.

Cancellation and switching

Complementary contracts in Luxembourg typically tacitly renew on an annual cycle. Cancellation requires written notice within a defined period before the renewal date — usually three months, but the exact number is set in the policy. Consumer law gives a short cooling-off period after signature to withdraw without penalty [verify exact duration in the insurer brochure and CAA guidance].

Specific life events also typically open the door to mid-contract cancellation: loss of CNS affiliation, departure from Luxembourg, change of family situation. These are spelled out in the policy under résiliation pour cas particulier or equivalent language. When switching providers, plan the timing so that the new policy's waiting periods do not leave a gap on dental, optical or maternity cover — switching mid-need is rarely advantageous.

Tax deductibility

Under the Loi de l'impôt sur le revenu (LIR), premiums paid for complementary health insurance are deductible from taxable income as dépenses spéciales — the same broad category that covers, among other items, life-insurance premiums, contributions to certain pension products and other personal expenses. The deduction is subject to a personal-allowance ceiling set in the LIR, which is shared across the eligible categories; once the ceiling is reached, additional premiums in the period do not produce additional tax relief.

The deduction is claimed on the annual form 100 declaration at the ACD; you attach the insurer's annual certificate showing the premiums paid. For most households, the deduction is material but not transformative: the ceiling caps it at a fraction of typical annual premiums for a family. The framework is stable, but the ceiling figure moves and we deliberately do not quote a current number on this page — confirm against the ACD's annual guidance. See tax classes explained for how dépenses spéciales fit into the overall declaration.

Provider comparison

The table below summarises the structural positioning of each main provider — not the premiums, which move and which depend on age, family and tier. For pricing, request quotes directly from each insurer; the CAA-approved product schedules and the brochures hold the binding terms.

Anything price-related — premium per month, dental ceiling in euros, optical envelope, hospital VIP supplement — is marked [verify] because the policy schedules change and we do not want to publish numbers that go stale. Take the structural picture above to the insurer brochures and compare like for like on the same age and family composition.

Edge cases

Cross-border workers. Some Luxembourg complementary insurers offer products designed for cross-border employees — covering treatment in the country of residence as well as in Luxembourg — while others reserve their main products to residents. The CAA-approved product schedule and the eligibility wording in the brochure determine the answer; ask before subscribing. The interaction with the country-of-residence sickness fund (via the S1 procedure, see the CNS guide) matters: complementary cover sits on top of CNS reimbursement, regardless of where the care is delivered.

Freelancers and the self-employed. Indépendants are CNS-affiliated through their direct CCSS registration and can subscribe to complementary insurance on the individual market. Group rates available to employees through employer-sponsored plans are not available to a solo freelancer; in practice this means slightly higher premiums or fewer waiver options on waiting periods. Check whether your professional order (OAI, chambres) negotiates collective complementary products for members.

Very high earners with international healthcare needs. For senior international hires, private international cover (Cigna, Bupa, Allianz International) is often arranged by the employer as a global plan alongside CNS affiliation. These plans look like premium complementary insurance but with direct-billing networks in major cities worldwide. Affiliation to the CNS remains mandatory in parallel; the international plan acts as a second layer.

Children's orthodontics. Orthodontics is the single largest household expense category in complementary insurance. CNS cover is restricted by age and conditions; complementary cover varies enormously by tier and by per-person vs per-family ceiling structure. If orthodontics is foreseeable, subscribe well in advance of the expected start date to clear the waiting periods, and read the orthodontic clause in detail.

What this means in practice

Three steps for someone choosing a plan:

1. Decide the tier before the provider. Most households start with basic or standard. Premium is worth it only if worldwide cover, hospital VIP or significant alternative medicine matter to you. Once the tier is decided, comparing across providers is faster.
2. Get quotes from at least three insurers at the same age and family composition. Compare premium, dental ceiling structure (per-person vs per-family), waiting periods on each category, and the cancellation terms. Read the orthodontic clause for any child likely to need it.
3. Subscribe well before any known event. Waiting periods on maternity (around 9–10 months), dental and optical mean that subscribing in anticipation of a known need rarely produces a payout. Subscribe early; the worst case is paying premium on a year you do not claim.

Frequently asked

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